In This Issue...

AHRQ Issues Report on Bundled Payments

The Agency for Healthcare Research and Quality (AHRQ) recently released a report, “Bundled Payment: Effects on Health Care Spending and Quality,” which evaluates the impact of this payment model on health care spending and quality. Bundled payments is one of the new Medicare reimbursement models being considered by the Centers for Medicare and Medicaid Services (CMS) as a result of the health care reform law of 2010. Under this scenario, providers would get paid a single payment for a pre-determined set of services.

Advocates for the bundled approach hope that the adoption of this payment model would reduce health care spending and the utilization of services. The AHRQ study gave proponents mixed news. The study does suggest that bundled payments do reduce overall health care spending and utilization with limited effects on quality of care. The Agency acknowledges, however, that the “strength of evidence” of the studies that were the basis of the report is low. To get a copy of the Agency study, please go to its web site.

CMS Releases Stage 2 Meaningful Use Final Rule

On August 23, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final rule regarding Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The rule specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) must meet in order to continue to participate in the EHR Incentive Programs. The final rule adds “outpatient lab reporting” to the menu for hospitals and “recording clinical notes” as a menu objective for both EPs and hospitals. Those covered health entities that successfully meet the meaningful requirements by July 1, 2014 will receive incentive payments while those providers that fail to meet the deadline will see a reduction in their 2015 payments. For a copy of the final rule, please visit the Federal Register Web site.

PCORI Holding Workshops to Engage Public and Stakeholders

The Patient Centered Outcomes Research Institute (PCORI) is holding three workshops this fall to get feedback from patients and the health care community on its draft process for generating and selecting specific research topics. The public-private evidence-based research group hopes to develop “topic-specific funding announcements” that correspond with its research priorities. To see a listing of the workshops, and to register, please go to the PCORI Web site.

CMS Announces New ICD-10 Implementation Date

On August 24, 2012, the Centers for Medicare and Medicaid Services (CMS) issued a final rule stating that the implementation date for the new International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10) is October 1, 2014. The ICD-10 system “will include codes for new procedures and diagnoses that improve the quality of information available for quality improvement and payment purposes.” A copy of the announcement is available in the Federal Register.

AHRQ Releases Serum Free Light Chain Study

The Agency for Healthcare Research and Quality (AHRQ) released another AACC sponsored study – “Serum Free Light Chain Analysis for the Diagnosis, Management and Prognosis of Plasma Cell Dyscrasias.” The purpose of this study is to “evaluate the present body of evidence addressing the relative effectiveness of the SFLC assay as compared with traditional tests for the diagnosis, management, and prognosis of PCDs.” This is the eighth AACC initiated study the agency has published since 2003—five more are in various stages of completion.

The AHRQ study concluded that there was not “sufficient evidence to determine whether the addition of the SFLC assay to traditional testing would increase the diagnostic accuracy of PCD and whether it would help prognosticate the disease course…Potential areas where its benefit may be seen are in diagnosis and prognosis, monitoring of therapy, and aiding treatment decisions. To view the report please go to the AHRQ web site.